Uric acid and gout as reflections of dysbiosis

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Better blood and urine ranges of uric acid could cause gout (painful uric acid crystal deposition in joints) and kidney illness. Extra just lately, uric acid has additionally been related to elevated threat for metabolic syndrome, sort 2 diabetes, heart problems, kidney and liver illness even within the absence of gout assaults, i.e., “asymptomatic hyperuricemia” or asymptomatic will increase in blood ranges of uric acid. Typical “remedies” contain lowering the dietary consumption of purines, i.e., the genetic (DNA and RNA) materials current in animal merchandise, and prescription drugs that block the enzyme, xanthine oxidase, that yields uric acid. As in so many different circumstances, the standard options deal with “downstream” phenomena however fail to deal with the precise trigger—not weight loss program, however disruptions of bowel flora composition with lack of microbial species which can be vigorous in metabolizing uric acid, thereby lowering blood and urine ranges. This science has been unfolding for in regards to the previous decade, but it surely has just lately galloped ahead with a flood of recent observations which can be yielding therapeutic potentialities in managing uric acid. (It additionally addresses a elementary flaw in typical pondering: Why would people, genetically-adapted over three million years to consuming animal merchandise reminiscent of meats, organs, and seafood, develop an intolerance to them? The issue just isn’t animal merchandise; it’s the capability to metabolize elements reminiscent of uric acid, disrupted by shifts in gastrointestinal (G) microbiome composition resulting from trendy life and maybe worsened by a nutrient- and polyphenol-poor trendy weight loss program.)

Individuals with gout and hyperuricemia have been proven to have 1) disrupted gastrointestinal microbiome composition with elevated Proteobacteria (fecal species) and mucin-degraders reminiscent of Bacteroides caccae, 2) elevated intestinal permeability, and three) elevated endotoxemia, all of which additional provides to irritation, insulin resistance, and susceptibility to heart problems. You’ll be able to admire that gout and hyperuricemia should not nearly uric acid, however a constellation of phenomena, a lot of which might be backtracked to a disrupted GI microbiome.

The record of gastrointestinal microbes that metabolize uric acid in varied methods is rising quickly, principally Lactobacillus species which have advanced to be environment friendly metabolizers of purines and different genetic materials. Among the many species/strains which were related to decreased blood and urinary ranges of uric acid embrace:

  • Lactobacillus brevis DSM9218
  • Lactobacillus plantarum WCFS1
  • Lactobacillus paracasei S12
  • Limosilactobacillus fermentum GR-3
  • Lacticaseibacillus paracasei MJM60396
  • Ligillactobacillus salivarius CECT 30632

A human examine of the final microbe listed, L. salivarius CECT 30632 at a day by day dose of 1 billion CFUs per day for six months, demonstrated a marked discount in gout episodes, reliance on gout treatment, and decreased blood ranges of uric acid in comparison with placebo.

Along with over proliferation of fecal microbes and mucin-degrading species, lack of necessary butyrate-producing species, Faecalibacterium prausnitzii and Bifidobacteria species, has additionally been documented. Though F. prausnitzii and Bifidobacteria species don’t themselves metabolize uric acid, they one way or the other help people who do. Recall that prebiotic fibers reminiscent of inulin/FOS trigger a “bloom” in these species, that will additionally add additional benefit. Additional, microbial metabolism of purines and different genetic materials is considerably elevated when glucose (sugar) is much less out there; in different phrases, a scenario by which insulin resistance and blood glucose are introduced underneath management might additional improve the microbiome’s capability to rid your physique of purines and thereby uric acid.

After all, you can attempt to receive and ferment a few of these species, as we do with our L. reuteri and L. gasseri yogurts to acquire excessive bacterial counts to make sure significant organic results reminiscent of eradication of SIBO, smoother pores and skin, elevated libido, decreased intestinal permeability and decreased endotoxemia. However, as you may admire, it turns into impractical to ferment every species we wish to colonize our GI tracts. Curiously, the vast majority of species that metabolize purines and thereby scale back uric acid come from fermented meals reminiscent of sauerkraut, pickles, and kimchi. Maybe in future we can receive a number of of these microbes reminiscent of L. salivarius CECT 30632 that you can ferment as yogurt to amplify uric acid-reducing results. There’s usually a a number of yr lag going from laboratory commentary to business availability, so these microbial strains should not but out there. Keep tuned.

By the way in which, uric acid just isn’t the one issue that’s proving to be a metabolic consequence of a disrupted gastrointestinal microbiome. Add oxalates, homocysteine, vitamin B12 deficiency, folate deficiency and a variety of different conditions which can be yielding to insights into the microbiome that, like uric acid, ought to trigger us to rethink all we thought we knew about these phenomena.

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